We welcome October rather lightly, sparingly, as it usually tethers between change and holding on. As the breeze cools slightly and we welcome a patchwork set of events – Ber months, Halloween, and a tinge of longing for autumn that can never be – we’re all encouraged to set our sights on something more important.

October has been designated as National Mental Health Month in the Philippines. From content on our screens to words we hear in the streets, we hear “you matter” and “you’re not alone,” phrases which have become steady responses to mental health advocacy psalms.

Indeed, you matter. And yes, you’re not alone. With millions of mental advocates worldwide, the dialogue should no longer be a question of awareness. We’ve moved a step further in the plane of changing the game, and we don’t realize the brand new, rather formidable — but invisible — blocks we’re facing. 

Individuals with mental health issues carry the burden of getting better. The messages we spread and use to raise awareness have succeeded in planting the seed of better understanding and overturning stereotypes, but we fail to see that mental health is a structural issue. 

Mental health goes beyond self-care guides, little treats, and taking a day off when necessary. It’s part of a systemic and political ladder. Underneath the good intentions of these undeniably positive reminders lie perfunctory obligations. 

Self-care guides necessitate proper allocation of resources. You need a good bed to rest and recuperate, as well as a working bathroom to house your skincare regimens. There’s not much room for self-care when squeezed into a small room with five other people trying to get some sort of respite. 

A minimum wage leaves no room for little treat purchases. Iced coffee and ice cream tubs have no business being on the list of necessities, a list which grows shorter by the day. Today, you can afford a kilo of rice. Tomorrow, who knows what your daily wage can get?

Taking a day off means fewer chances of surviving the day. “Take a day to yourself; you deserve it.” True, but if you work under a “no work, no pay” policy, taking mental health days seems like a crime – a dangerous territory that should never be crossed. 

Thankfully, efforts to raise mental health awareness have pushed more to accept therapy and counseling sessions, along with other mental health interventions. All these have likely helped save countless lives, empowering individuals to finally name what plagues their minds. Once you’ve named it, you hold power over it. 

With the help of advocates and healthcare workers, we’ve changed the game forever. 

But it’s still not enough. There are so many more layers left to peel, and we need to begin moving towards putting mental health at scale. Why?

What do you say to people who uncover that their mental health issues stem from job insecurity, poverty, substance abuse problems, health issues, abusive environments, and lack of SOGIE protection, just to name a few?

In a global survey by the FWD Group Holdings Limited, 63% of Filipinos believe that current economic challenges significantly affect mental health. And with the current minimum wage in the National Capital Region only standing between P573 to P610, the prospects are fraught. What’s more, the Philippine Statistics Authority posits that there is a 4.8% unemployment rate across the country as of January 2023.

The healthcare setting is also barbed-wired territory, with medical workers still getting less than they deserve. In particular, the ratio of mental health workers per population in the Philippines is low, standing at an alarming 2 to 3 professionals per 100,000 people. Patients without health insurance continue to brave the heat and inhumane human lines to get financial help — with their mental health out of the equation. 

Art expressions like drag — existing within a community founded on love, bravery, and trust — are persecuted because we mask acceptance with surface-level, conditional tolerance. And day by day, it becomes even more impossible to make people listen to SOGIE. What of the artists’ mental health, suffering daily under public duress?

Placed side by side, these pillars of reality show us how self-care guides, “deserve mo” treats, and days off hold little to no value here. The mental struggles persist due to situations they cannot control, so what kind of impact does the narrative of “you matter” truly hold? 

The Mental Health Act of 2017 mandates the Department of Health (DOH) to provide and support “psychiatric and neurological psychosocial services” to hospitals nationwide. It also compels the agency to invest in capacity-building for mental health professionals and health service personnel. It also places those struggling with mental disorders protection against stigma and discrimination.

But our fight asks for more. Right now, we heed that the individual shouldn’t solely carry the burden of recovery, because merely wanting to be better isn’t enough to break through walls of economic insecurity and social injustice. Similarly, the burden shouldn’t be on mental health advocates alone, because the barrier does not open unless pulled open by those with their hands on the lever. 

Positive reminders, talks, and social media posts should coincide with more comprehensive and consistent government interventions, as well as constantly challenging structural barriers in place. 

After all, to be in a good mental state means being able to afford therapy.

It means having a safe home to come home to at the end of the day and not suffer hours upon hours of long commutes. 

It means having unrestricted access to nourishment through good food and affordable medications. 

It means having the freedom to exist in a safe space without suffering from senseless stress trying to defend expression and identity. 

It means being able to trust in a healthcare system that leaves space for everyone, especially the almost non-functional mentally ill.

Most importantly, it also means being a Filipino afforded the dignity to live as a citizen of their own country. 

That responsibility lies on the shoulders of those whose hands forge legislation and whose minds and stature warrant them the right to trailblaze changes. 

This October and beyond, we must begin pushing the notion that mental health issues require more than just dialogue and affirmations. 

You matter. But so does the system’s role in your recovery. It shouldn’t subject you to only less, much less force you to bother with “only to an extent.” – Rappler.com

Nicole Tengco is a 25-year-old writer from Manila.